Eemalda osaleja

X006 - Eemalda osaleja

SED API version: 0.16.2 build 2
Model version: 4.2.0

Juhtumi taustteave * [ SC ]

Isiku taustteave * [ CC ]

Tööandja taustteave * [ CC ]

Tagasimakse taustteave * [ SC ]

Perekonnanimi(-nimed) *

[ BDT ] {{metaSection.familyName.$$error}} {{metaSection.familyName.$$warning}}

Eesnimi (-nimed) *

[ BDT ] {{metaSection.forename.$$error}} {{metaSection.forename.$$warning}}

Sünniaeg *

[ BDT ] {{metaSection.dateBirth.$$error}} {{metaSection.dateBirth.$$warning}}

Sugu *

[ ENUM ] {{metaSection.sex.$$error}} {{metaSection.sex.$$warning}}

Nimi *

[ CDT ] {{metaSection.name.$$error}} {{metaSection.name.$$warning}}

Identifitseerimisnumbrid [ CC ]

Identifitseerimisnumber [ CC ]

Number *

[ CDT ] {{metaSection.number.$$error}} {{metaSection.number.$$warning}}

Liik *

[ ENUM ] {{metaSection.type.$$error}} {{metaSection.type.$$warning}}

Identifitseerimisnumber

Aadress [ CC ]

Tänav

[ CDT ] {{metaSection.street.$$error}} {{metaSection.street.$$warning}}

Hoone nimi

[ CDT ] {{metaSection.buildingName.$$error}} {{metaSection.buildingName.$$warning}}

Linn *

[ CDT ] {{metaSection.town.$$error}} {{metaSection.town.$$warning}}

Sihtnumber

[ CDT ] {{metaSection.postalCode.$$error}} {{metaSection.postalCode.$$warning}}

Piirkond

[ CDT ] {{metaSection.region.$$error}} {{metaSection.region.$$warning}}

Riik *

[ ENUM ] {{metaSection.country.$$error}} {{metaSection.country.$$warning}}

Tagasimakse taotluse ID *

[ BDT ] {{metaSection.reimbursementRequestID.$$error}} {{metaSection.reimbursementRequestID.$$warning}}

Üksiknõuete koguarv *

[ BDT ] {{metaSection.totalNumberIndividualClaims.$$error}} {{metaSection.totalNumberIndividualClaims.$$warning}}

Eemaldatud osaleja * [ SED ]

Asutus * [ CC ]

Asutuse identifitseerimisnumber *

[ BDT ] {{metaSection.institutionID.$$error}} {{metaSection.institutionID.$$warning}}

Asutuse nimi *

[ CDT ] {{metaSection.institutionName.$$error}} {{metaSection.institutionName.$$warning}}

Põhjus

[ ENUM ] {{metaSection.reason.$$error}} {{metaSection.reason.$$warning}}

Kui valite „99 - Muu“, siis esitage lisaandmed

[ CDT ] {{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$error}} {{metaSection.pleaseProvideMoreDetailsIf99OtherSelected.$$warning}}

{{ row.severityMessage }} : {{ row.message }}